Shortage of GPs strikes at the heart '¨of health service

GPs are the bedrock on which the NHS is built. Without a properly functioning GP service patients will be diagnosed incorrectly, too late or perhaps not all.

Some will die unnecessarily; others will require lengthier and more expensive treatment as a result of simple failures at the primary care level.

Few could disagree with this harsh reality, and yet the crisis in our GP services across Scotland fails to get the headlines it deserves.

We report today that 99 GP practices across Scotland are imposing some form of restriction for new patients – around one in ten of the overall total. Of these, 51 are in the Lothians with the next highest region being Fife, which imposes limits in 20 medical practices.

This means that if for some reason you are not registered, you may be told to find a surgery several miles away. A slight inconvenience for some, but a major issue if you don’t drive or have mobility issues.

Even those who are registered can find themselves waiting weeks for an appointment or being told to telephone every morning in the hope of gaining one on the day. As a reader said recently: “It’s easier getting One Direction tickets than phoning for a GP appointment.”

The issue has been caused by the perfect storm of more and more experienced doctors taking early retirement, going part-time or moving into private practice, while not enough new doctors are being trained. Many of those who do qualify have no desire to enter general practice. It has led some GPs to say that the state of general practice in Scotland is the worst it has been for a generation.

The most seriously affected areas are those with an increasing population, which is why Lothian stands out. The Scottish Government has set ambitious housebuilding targets and yet local surgeries are unable to keep up with the demand.

Estimates suggest 618,978 people will live in Edinburgh alone by 2037, compared with 498,810 in 2015, a rise of more than 120,000 in just over 20 years.

The ongoing GP recruitment crisis has led the Royal College of General Practitioners to forecast a shortage of 856 GPs by 2021.

Make no mistake, this issue will become more acute and needs to be tackled immediately by the Scottish Government and the NHS. It takes five to eight years to train a GP, so planning is essential. It is not possible to create thousands of GPs overnight.

Funding is also an issue. It can take around £200,000 of public money to train a GP and so plugging this gap is also expensive.

Simply looking to recruit GPs from overseas is only part of the solution.

The new GP contract will help but there are fundamental issues to be tackled. One certainty is that we need to train more GPs for the future even if the fruits of this investment will not be seen during the terms of our current crop of politicians.